Bashawaty, Wally
Bashawaty, Wally is an sole proprietor health care provider with primary practice located at 1501 Superior Ave Ste 306 , Newport Beach CA 92663-3641. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Bashawaty, Wally can be contacted via phone (949) 645-8222.Contact Information
Primary practice address
1501 Superior Ave Ste 306
Newport Beach CA 92663-3641
Phone: (949) 645-8222
Fax: (949) 645-3111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 45429 | California |
Profile Details
| NPI number | 1780721621 |
|---|---|
| LBN Legal business name | Bashawaty, Wally |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780721621 | NPPES |
| California | Other | 831034 | UNITED CONCORDIA PROVIDER |
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